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What you need to know about sciatica: a type of back pain

August 10, 2018

Back pain can be the result of any number of problems, from simple muscle fatigue that can be managed with over-the-counter pain relievers, to more serious issues that might need more powerful medications or surgery. Other conditions, for example diabetes, can injure nerves and cause pain in the extremities. Sciatica, however, is a specific type of back pain that generally starts with a herniated disc in the lower (lumbar) spine.

A herniation occurs when the flat, round disc of flexible connective tissue becomes worn from age or injury, and the soft center area starts to push out or herniate. This can put a great deal of pressure on the surrounding nerves, causing tremendous pain.

The longest peripheral nerve in the body, the sciatic nerve, controls the movement of the feet and sensation along the posterior (back) part of the lower extremities. The sciatic nerve starts in the lower back and forks out through the hips, legs, and feet. Any sort of pressure applied to the nerves from bone spurs, herniated disks, or soft tissues can be very painful.

What are the symptoms?

In addition to severe pain, sciatica can cause weakness that begins in the lower back and extends into the legs. “It’s usually a sharp, shooting, electrical pain that can actually be worse when sitting down and is accompanied by numbness or tingling,” explains Kamal Woods, MD, neurosurgeon for Brain & Spine at Kettering Health Network.

To properly diagnose the problem, your doctor will evaluate your lifestyle, work, and exercise habits, and do a physical exam. For those who have experienced long-term pain, X-rays, CT scans and MRIs can help identify bone spurs or herniated disks, which are the primary causes of sciatic pain.

Who does sciatica affect?

The vast majority of sciatica patients are between 30 and 50 years old, and risk factors vary. Those who are overweight, or women who are pregnant, tend to have a higher chance of experiencing a herniated disk that results in sciatic pain. People with jobs that require heavy lifting and even prolonged sitting can experience a damaged disk, again causing sciatic pain.

“We tend to see sciatic pain in two groups of people: those who are young and active and may have overexerted or injured something, or older people with bone spurs,” Dr. Woods says.

When should I see a doctor?

Most of the time, sciatica patients recover in just a few weeks without surgery. While you might be inclined to rest when experiencing sciatic pain, it’s actually quite important to keep moving. Staying active can help reduce inflammation and the need for long-term use of medication. In addition, special stretches are available that target lower back and sciatic pain. Physical therapy or possibly steroid injections can help relieve the discomfort, as well.

If you are experiencing sciatic pain accompanied by bowel or bladder incontinence, Dr. Woods urges you to go to the Emergency Department right away. “Otherwise, we usually just recommend taking over-the-counter pain relievers that are nonsteroidal anti-inflammatory drugs and avoiding any heavy lifting for several days,” he says. For persistent pain lasting more than a few months, surgical remedies may be necessary.

Sciatica is a common condition, and while many people suffer from back pain at some time in their lives, most will get better if treated appropriately. “If the pain doesn’t get better and surgery is required, there are now minimally invasive ways to treat the problem, with a less than one-inch incision,” Dr. Woods says. “Outpatient surgeries enable patients to return to their work, family, and hobbies quickly.”